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Graça J, Campos L, Guedes D, Roque L, Brazão V, Truninger M, Godinho C. How to enable healthier and more sustainable food practices in collective meal contexts: A scoping review. Appetite 2023; 187:106597. [PMID: 37178929 DOI: 10.1016/j.appet.2023.106597] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 05/01/2023] [Accepted: 05/09/2023] [Indexed: 05/15/2023]
Abstract
Collective meal contexts such as restaurants, cafeterias and canteens can help accelerate transitions to healthier and more sustainable diets. However, evidence from intervention studies on these contexts lacks integration. This scoping review aimed to map determinants of dietary change in collective meal contexts across multiple settings, interventions, target groups, and target behaviors. The review provided two main outcomes: (i) identifying intervention components to promote dietary change in collective meal contexts, based on the existing body of evidence; and (ii) classifying and integrating these intervention components into an overarching framework of behavior change (i.e., COM-B system). The review encompassed twenty-eight databases via two indexing services and extracted information from 232 primary sources (27,458 records selected for title and abstract screening, 574 articles selected for full-text screening). We identified a total of 653 intervention activities, which were classified into intervention components and grouped under three broad themes, namely contextual and environmental changes, social influence, and knowledge and behavioral regulation. Multi-component interventions tended to report overall positive outcomes. The review proposes several directions for future research, including: (i) moving toward more theory-based interventions in collective meal contexts; (ii) providing more detailed information about intervention settings, implementation, target groups, activities, and materials; and (iii) improving the use of open science practices in the field. Furthermore, the review offers a free, original, open-access list and synthesis of 277 intervention studies in collective meal contexts, which can help intervention planners and evaluators optimize their efforts to promote healthier and more sustainable food practices in these contexts.
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Affiliation(s)
- João Graça
- University of Groningen, Groningen, the Netherlands; Instituto de Ciências Sociais da Universidade de Lisboa (ICS-ULisboa), Lisboa, Portugal.
| | - Lúcia Campos
- Instituto de Ciências Sociais da Universidade de Lisboa (ICS-ULisboa), Lisboa, Portugal; Iscte - Instituto Universitário de Lisboa, CIS_Iscte, Portugal
| | - David Guedes
- Instituto de Ciências Sociais da Universidade de Lisboa (ICS-ULisboa), Lisboa, Portugal; Iscte - Instituto Universitário de Lisboa, CIS_Iscte, Portugal
| | - Lisa Roque
- Iscte - Instituto Universitário de Lisboa, CIS_Iscte, Portugal
| | | | - Monica Truninger
- Instituto de Ciências Sociais da Universidade de Lisboa (ICS-ULisboa), Lisboa, Portugal
| | - Cristina Godinho
- NOVA National School of Public Health, Public Health Research Center, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal
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Johansson JF, Lam N, Ozer S, Hall J, Morton S, English C, Fitzsimons CF, Lawton R, Forster A, Clarke D. Systematic review of process evaluations of interventions in trials investigating sedentary behaviour in adults. BMJ Open 2022; 12:e053945. [PMID: 35105631 PMCID: PMC8804646 DOI: 10.1136/bmjopen-2021-053945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To systematically review and synthesise findings from process evaluations of interventions in trials which measured sedentary behaviour as an outcome in adults to explore: (1) how intervention content, implementation, mechanisms of impact and context influence outcomes and (2) how these interventions are experienced from different perspectives (participants, carers, staff). DESIGN Systematic review and narrative synthesis underpinned by the Medical Research Council process evaluation framework. DATA SOURCES Databases searches were conducted in March 2019 then updated in May 2020 and October 2021 in: CINAHL, SPORTDiscus, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, AMED; EMBASE, PsycINFO, MEDLINE, Web of Science and ProQuest Dissertations & Theses. ELIGIBILITY CRITERIA We included: Process evaluations of trials including interventions where sedentary behaviour was measured as an outcome in adults aged 16 or over from clinical or non-clinical populations. We excluded studies if interventions were delivered in educational or workplace settings, or if they were laboratory studies focused on immediate effects of breaking sitting. DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted and coded data into a framework and assessed the quality of studies using the Mixed Methods Appraisal Tool. We synthesised findings using a narrative approach. RESULTS 17 process evaluations were included. Five interventions focused on reducing sedentary behaviour or sitting time, 12 aimed to increase physical activity or promote healthier lifestyles. Process evaluations indicated changes in sedentary behaviour outcomes were shaped by numerous factors including: barriers (eg, staffing difficulties and scheduling problems) and facilitators (eg, allowing for flexibility) to intervention delivery; contextual factors (eg, usual lifestyle and religious events) and individual factors (eg, pain, tiredness, illness, age and individual preferences). DISCUSSION Intervention requires careful consideration of different factors that could influence changes in sedentary behaviour outcomes to ensure that interventions can be tailored to suit different individuals and groups. PROSPERO REGISTRATION NUMBER CRD42018087403.
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Affiliation(s)
- Jessica Faye Johansson
- Academic Unit for Ageing and Stroke Research, University of Leeds, Leeds Institute of Health Sciences, Leeds, UK
- Academic Unit for Ageing and Stroke Research, Bradford Institute for Health Research, Bradford, UK
| | - Natalie Lam
- Academic Unit for Ageing and Stroke Research, University of Leeds, Leeds Institute of Health Sciences, Leeds, UK
- Academic Unit for Ageing and Stroke Research, Bradford Institute for Health Research, Bradford, UK
| | - Seline Ozer
- Academic Unit for Ageing and Stroke Research, University of Leeds, Leeds Institute of Health Sciences, Leeds, UK
- Academic Unit for Ageing and Stroke Research, Bradford Institute for Health Research, Bradford, UK
| | - Jennifer Hall
- Academic Unit for Ageing and Stroke Research, Bradford Institute for Health Research, Bradford, UK
- Faculty of Life Sciences and Health Studies, University of Bradford, Bradford, UK
| | - Sarah Morton
- Geriatric Medicine, The University of Edinburgh Centre for Clinical Brain Sciences, Edinburgh, UK
| | - Coralie English
- Faculty of Health and Medicine, The University of Newcastle School of Health Sciences, Callaghan, New South Wales, Australia
| | - Claire F Fitzsimons
- Institute of Sport, Physical Education and Health Sciences, University of Edinburgh Physical Activity for Health Research Centre, Edinburgh, UK
| | - Rebecca Lawton
- Institute of Psychological Sciences, University of Leeds, Leeds, UK
- Quality and Safety Research, Bradford Institute for Health Research, Bradford, UK
| | - Anne Forster
- Academic Unit for Ageing and Stroke Research, University of Leeds, Leeds Institute of Health Sciences, Leeds, UK
- Academic Unit for Ageing and Stroke Research, Bradford Institute for Health Research, Bradford, UK
| | - David Clarke
- Academic Unit for Ageing and Stroke Research, University of Leeds, Leeds Institute of Health Sciences, Leeds, UK
- Academic Unit for Ageing and Stroke Research, Bradford Institute for Health Research, Bradford, UK
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Marques MM, Carey RN, Norris E, Evans F, Finnerty AN, Hastings J, Jenkins E, Johnston M, West R, Michie S. Delivering Behaviour Change Interventions: Development of a Mode of Delivery Ontology. Wellcome Open Res 2021; 5:125. [PMID: 33824909 PMCID: PMC7993627 DOI: 10.12688/wellcomeopenres.15906.2] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2021] [Indexed: 12/16/2022] Open
Abstract
Background: Investigating and improving the effects of behaviour change interventions requires detailed and consistent specification of all aspects of interventions. An important feature of interventions is the way in which these are delivered, i.e. their mode of delivery. This paper describes an ontology for specifying the mode of delivery of interventions, which forms part of the Behaviour Change Intervention Ontology, currently being developed in the Wellcome Trust funded Human Behaviour-Change Project. Methods: The Mode of Delivery Ontology was developed in an iterative process of annotating behaviour change interventions evaluation reports, and consulting with expert stakeholders. It consisted of seven steps: 1) annotation of 110 intervention reports to develop a preliminary classification of modes of delivery; 2) open review from international experts (n=25); 3) second round of annotations with 55 reports to test inter-rater reliability and identify limitations; 4) second round of expert review feedback (n=16); 5) final round of testing of the refined ontology by two annotators familiar and two annotators unfamiliar with the ontology; 6) specification of ontological relationships between entities; and 7) transformation into a machine-readable format using the Web Ontology Language (OWL) and publishing online. Results: The resulting ontology is a four-level hierarchical structure comprising 65 unique modes of delivery, organised by 15 upper-level classes: Informational , Environmental change, Somatic, Somatic alteration, Individual-based/ Pair-based /Group-based, Uni-directional/Interactional, Synchronous/ Asynchronous, Push/ Pull, Gamification, Arts feature. Relationships between entities consist of is_a. Inter-rater reliability of the Mode of Delivery Ontology for annotating intervention evaluation reports was a=0.80 (very good) for those familiar with the ontology and a= 0.58 (acceptable) for those unfamiliar with it. Conclusion: The ontology can be used for both annotating and writing behaviour change intervention evaluation reports in a consistent and coherent manner, thereby improving evidence comparison, synthesis, replication, and implementation of effective interventions.
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Affiliation(s)
- Marta M. Marques
- Centre for Behaviour Change, University College London, London, UK
- ADAPT SFI Research Centre, Trinity College Dublin, Dublin, Ireland
- Trinity Centre for Healthcare and Practice Innovation, Trinity College Dublin, Dublin, Ireland
| | - Rachel N. Carey
- Centre for Behaviour Change, University College London, London, UK
| | - Emma Norris
- Centre for Behaviour Change, University College London, London, UK
| | - Fiona Evans
- Centre for Behaviour Change, University College London, London, UK
| | | | - Janna Hastings
- Centre for Behaviour Change, University College London, London, UK
| | - Ella Jenkins
- Centre for Behaviour Change, University College London, London, UK
| | - Marie Johnston
- Aberdeen Health Psychology Group, University of Aberdeen, Aberdeen, Scotland, UK
| | - Robert West
- Research Department of Epidemiology & Public Health, University College London, London, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, UK
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Michie S, Johnston M, Rothman AJ, de Bruin M, Kelly MP, Carey RN, Bohlen LEC, Groarke HNK, Anderson NC, Zink S. Developing an evidence-based online method of linking behaviour change techniques and theoretical mechanisms of action: a multiple methods study. HEALTH SERVICES AND DELIVERY RESEARCH 2021. [DOI: 10.3310/hsdr09010] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background
Many global health challenges may be targeted by changing people’s behaviour. Behaviours including cigarette smoking, physical inactivity and alcohol misuse, as well as certain dietary behaviours, contribute to deaths and disability by increasing the risk of cancers, cardiovascular diseases and diabetes. Interventions have been designed to change these health behaviours with a view to reducing these health risks. However, the effectiveness of these interventions has been quite variable and further information is needed to enhance their success. More information is needed about the specific processes that underlie the effectiveness of intervention strategies.
Aim
Researchers have developed a taxonomy of 93 behaviour change techniques (i.e. the active components of an intervention that bring about behavioural change), but little is known regarding their potential mechanisms of action (i.e. the processes through which a behaviour change technique affects behaviour). We therefore aimed to examine links between behaviour change techniques and mechanisms of action.
Method
First, we conducted a literature synthesis study of 277 behaviour change intervention studies, from which we extracted information on links, described by authors, between behaviour change techniques and mechanisms of action, and identified an average of 10 links per intervention report. Second, behaviour change experts (n = 105) were engaged in a three-round consensus study in which they discussed and rated their confidence in the presence/absence of ‘links’ and ‘non-links’ between commonly used behaviour change techniques (n = 61) and a set of mechanisms of action (n = 26). Ninety links and 460 ‘non-links’ reached the pre-set threshold of 80% agreement. To enhance the validity of these results, a third study was conducted that triangulated the findings of the first two studies. Discrepancies and uncertainties between the studies were included in a reconciliation consensus study with a new group of experts (n = 25). The final results identified 92 definite behaviour change technique–mechanism of action links and 465 definite non-links. In a fourth study, we examined whether or not groups of behaviour change techniques used together frequently across interventions revealed shared theoretical underpinnings. We found that experts agreed on the underlying theory for three groups of behaviour change techniques.
Results
Our results are potentially useful to policy-makers and practitioners in selecting behaviour change techniques to include in behaviour change interventions. However, our data do not demonstrate that the behaviour change techniques are effective in targeting the mechanism of action; rather, the links identified may be the ‘best bets’ for interventions that are effective in changing mechanisms of action, and the non-links are unlikely to be effective. Researchers examining effectiveness of interventions in either primary studies or evidence syntheses may consider these links for further investigation.
Conclusion
To make our results usable by researchers, practitioners and policy-makers, they are available in an online interactive tool, which enables discussion and collaboration (https://theoryandtechniquetool.humanbehaviourchange.org/); accessed 1 March 2020. This work, building on previous work to develop the behaviour change technique taxonomy, is part of an ongoing programme of work: the Human Behaviour Change Project (www.humanbehaviourchange.org/; accessed 1 March 2020).
Funding
This project was funded by the Medical Research Council via its Methodology Panel: ‘Developing methodology for designing and evaluating theory-based complex interventions: an ontology for linking behaviour change techniques to theory’ (reference MR/L011115/1).
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Affiliation(s)
- Susan Michie
- Centre for Behaviour Change, University College London, London, UK
| | - Marie Johnston
- Institute of Applied Health Sciences, College of Life Sciences and Medicine, University of Aberdeen, Aberdeen, UK
| | | | - Marijn de Bruin
- Institute of Applied Health Sciences, College of Life Sciences and Medicine, University of Aberdeen, Aberdeen, UK
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands
| | - Michael P Kelly
- Primary Care Unit, Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Rachel N Carey
- Centre for Behaviour Change, University College London, London, UK
| | - Lauren EC Bohlen
- Centre for Behaviour Change, University College London, London, UK
- Department of Kinesiology, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Hilary NK Groarke
- Department of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Niall C Anderson
- Centre for Behaviour Change, University College London, London, UK
- National Institute for Health Research (NIHR) Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
| | - Silje Zink
- Centre for Behaviour Change, University College London, London, UK
- National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
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5
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Zou YH, Guan PP, Zhang SQ, Guo YS, Wang P. Rofecoxib Attenuates the Pathogenesis of Amyotrophic Lateral Sclerosis by Alleviating Cyclooxygenase-2-Mediated Mechanisms. Front Neurosci 2020; 14:817. [PMID: 32903591 PMCID: PMC7438558 DOI: 10.3389/fnins.2020.00817] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 07/13/2020] [Indexed: 12/11/2022] Open
Abstract
Cyclooxygenase-2 (COX-2) is reported to be activated during the course of amyotrophic lateral sclerosis (ALS) development and progression. However, the roles of COX-2 in aggravating ALS and the underlying mechanism have been largely overlooked. To reveal the mechanisms, the canonical SOD1G93A mouse model was used as an experimental model for ALS in the current study. In addition, a specific inhibitor of COX-2 activity, rofecoxib, was orally administered to SOD1G93A mice. With this in vivo approach, we revealed that COX-2 proinflammatory signaling cascades were inhibited by rofecoxib in SOD1G93A mice. Specifically, the protein levels of COX-2, interleukin (IL)-1β, and tumor necrosis factor (TNF)-α were elevated as a result of activation of astrocytes and microglia during the course of ALS development and progression. These proinflammatory reactions may contribute to the death of neurons by triggering the movement of astrocytes and microglia to neurons in the context of ALS. Treatment with rofecoxib alleviated this close association between glial cells and neurons and significantly decreased the density of inflammatory cells, which helped to restore the number of motor neurons in SOD1G93A mice. Mechanistically, rofecoxib treatment decreased the expression of COX-2 and its downstream signaling targets, including IL-1β and TNF-α, by deactivating glial cells, which in turn ameliorated the progression of SOD1G93A mice by postponing disease onset and modestly prolonging survival. Collectively, these results provide novel insights into the mechanisms of ALS and aid in the development of new drugs to improve the clinical treatment of ALS.
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Affiliation(s)
- Yan-Hui Zou
- College of Life and Health Sciences, Northeastern University, Shenyang, China
| | - Pei-Pei Guan
- College of Life and Health Sciences, Northeastern University, Shenyang, China
| | - Shen-Qing Zhang
- College of Life and Health Sciences, Northeastern University, Shenyang, China
| | - Yan-Su Guo
- Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Pu Wang
- College of Life and Health Sciences, Northeastern University, Shenyang, China
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6
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Marques MM, Carey RN, Norris E, Evans F, Finnerty AN, Hastings J, Jenkins E, Johnston M, West R, Michie S. Delivering Behaviour Change Interventions: Development of a Mode of Delivery Ontology. Wellcome Open Res 2020; 5:125. [PMID: 33824909 PMCID: PMC7993627 DOI: 10.12688/wellcomeopenres.15906.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2020] [Indexed: 12/16/2022] Open
Abstract
Background: Investigating and improving the effects of behaviour change interventions requires detailed and consistent specification of all aspects of interventions. An important feature of interventions is the way in which these are delivered, i.e. their mode of delivery. This paper describes an ontology for specifying the mode of delivery of interventions, which forms part of the Behaviour Change Intervention Ontology, currently being developed in the Wellcome Trust funded Human Behaviour-Change Project. Methods: The Mode of Delivery Ontology was developed in an iterative process of annotating behaviour change interventions evaluation reports, and consulting with expert stakeholders. It consisted of seven steps: 1) annotation of 110 intervention reports to develop a preliminary classification of modes of delivery; 2) open review from international experts (n=25); 3) second round of annotations with 55 reports to test inter-rater reliability and identify limitations; 4) second round of expert review feedback (n=16); 5) final round of testing of the refined ontology by two annotators familiar and two annotators unfamiliar with the ontology; 6) specification of ontological relationships between entities; and 7) transformation into a machine-readable format using the Web Ontology Language (OWL) language and publishing online. Results: The resulting ontology is a four-level hierarchical structure comprising 65 unique modes of delivery, organised by 15 upper-level classes: Informational , Environmental change, Somatic, Somatic alteration, Individual-based/ Pair-based /Group-based, Uni-directional/Interactional, Synchronous/ Asynchronous, Push/ Pull, Gamification, Arts feature. Relationships between entities consist of is_a. Inter-rater reliability of the Mode of Delivery Ontology for annotating intervention evaluation reports was a=0.80 (very good) for those familiar with the ontology and a= 0.58 (acceptable) for those unfamiliar with it. Conclusion: The ontology can be used for both annotating and writing behaviour change intervention evaluation reports in a consistent and coherent manner, thereby improving evidence comparison, synthesis, replication, and implementation of effective interventions.
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Affiliation(s)
- Marta M. Marques
- Centre for Behaviour Change, University College London, London, UK
- ADAPT SFI Research Centre, Trinity College Dublin, Dublin, Ireland
- Trinity Centre for Healthcare and Practice Innovation, Trinity College Dublin, Dublin, Ireland
| | - Rachel N. Carey
- Centre for Behaviour Change, University College London, London, UK
| | - Emma Norris
- Centre for Behaviour Change, University College London, London, UK
| | - Fiona Evans
- Centre for Behaviour Change, University College London, London, UK
| | | | - Janna Hastings
- Centre for Behaviour Change, University College London, London, UK
| | - Ella Jenkins
- Centre for Behaviour Change, University College London, London, UK
| | - Marie Johnston
- Aberdeen Health Psychology Group, University of Aberdeen, Aberdeen, Scotland, UK
| | - Robert West
- Research Department of Epidemiology & Public Health, University College London, London, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, UK
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Hunt K, Wyke S, Bunn C, Donnachie C, Reid N, Gray CM. Scale-Up and Scale-Out of a Gender-Sensitized Weight Management and Healthy Living Program Delivered to Overweight Men via Professional Sports Clubs: The Wider Implementation of Football Fans in Training (FFIT). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E584. [PMID: 31963224 PMCID: PMC7014345 DOI: 10.3390/ijerph17020584] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 01/07/2020] [Accepted: 01/08/2020] [Indexed: 12/11/2022]
Abstract
Increasing prevalence of obesity poses challenges for public health. Men have been under-served by weight management programs, highlighting a need for gender-sensitized programs that can be embedded into routine practice or adapted for new settings/populations, to accelerate the process of implementing programs that are successful and cost-effective under research conditions. To address gaps in examples of how to bridge the research to practice gap, we describe the scale-up and scale-out of Football Fans in Training (FFIT), a weight management and healthy living program in relation to two implementation frameworks. The paper presents: the development, evaluation and scale-up of FFIT, mapped onto the PRACTIS guide; outcomes in scale-up deliveries; and the scale-out of FFIT through programs delivered in other contexts (other countries, professional sports, target groups, public health focus). FFIT has been scaled-up through a single-license franchise model in over 40 UK professional football clubs to 2019 (and 30 more from 2020) and scaled-out into football and other sporting contexts in Australia, Canada, New Zealand, England and other European countries. The successful scale-up and scale-out of FFIT demonstrates that, with attention to cultural constructions of masculinity, public health interventions can appeal to men and support them in sustainable lifestyle change.
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Affiliation(s)
- Kate Hunt
- Institute for Social Marketing, University of Stirling, Stirling FK9 4LA, UK
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8QQ, UK; (S.W.); (C.B.); (C.D.); (C.M.G.)
- Department of Psychology, Curtin University, Bentley, WA 6102, Australia
| | - Sally Wyke
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8QQ, UK; (S.W.); (C.B.); (C.D.); (C.M.G.)
| | - Christopher Bunn
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8QQ, UK; (S.W.); (C.B.); (C.D.); (C.M.G.)
| | - Craig Donnachie
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8QQ, UK; (S.W.); (C.B.); (C.D.); (C.M.G.)
| | - Nicky Reid
- Scottish Professional League Trust (SPFL-T), Glasgow G42 9DE, UK;
| | - Cindy M. Gray
- Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8QQ, UK; (S.W.); (C.B.); (C.D.); (C.M.G.)
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8
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Michie S, Carey RN, Johnston M, Rothman AJ, de Bruin M, Kelly MP, Connell LE. From Theory-Inspired to Theory-Based Interventions: A Protocol for Developing and Testing a Methodology for Linking Behaviour Change Techniques to Theoretical Mechanisms of Action. Ann Behav Med 2019; 52:501-512. [PMID: 27401001 PMCID: PMC6367898 DOI: 10.1007/s12160-016-9816-6] [Citation(s) in RCA: 190] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Understanding links between behaviour change techniques (BCTs) and mechanisms of action (the processes through which they affect behaviour) helps inform the systematic development of behaviour change interventions. Purpose This research aims to develop and test a methodology for linking BCTs to their mechanisms of action. Methods Study 1 (published explicit links): Hypothesised links between 93 BCTs (from the 93-item BCT taxonomy, BCTTv1) and mechanisms of action will be identified from published interventions and their frequency, explicitness and precision documented. Study 2 (expert-agreed explicit links): Behaviour change experts will identify links between 61 BCTs and 26 mechanisms of action in a formal consensus study. Study 3 (integrated matrix of explicit links): Agreement between studies 1 and 2 will be evaluated and a new group of experts will discuss discrepancies. An integrated matrix of BCT-mechanism of action links, annotated to indicate strength of evidence, will be generated. Study 4 (published implicit links): To determine whether groups of co-occurring BCTs can be linked to theories, we will identify groups of BCTs that are used together from the study 1 literature. A consensus exercise will be used to rate strength of links between groups of BCT and theories. Conclusions A formal methodology for linking BCTs to their hypothesised mechanisms of action can contribute to the development and evaluation of behaviour change interventions. This research is a step towards developing a behaviour change ‘ontology’, specifying relations between BCTs, mechanisms of action, modes of delivery, populations, settings and types of behaviour.
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Affiliation(s)
- Susan Michie
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Rachel N Carey
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | | | | | | | | | - Lauren E Connell
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Grace-Farfaglia P. Social Cognitive Theories and Electronic Health Design: Scoping Review. JMIR Hum Factors 2019; 6:e11544. [PMID: 31325290 PMCID: PMC6676794 DOI: 10.2196/11544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 11/24/2018] [Accepted: 03/31/2019] [Indexed: 12/30/2022] Open
Abstract
Background There are several social cognitive theories (SCTs) and models that support platform design in electronic health (eHealth) promotion trials. The rationale for this scoping review was to determine how social design features (informational aid, expressive support, gaming, and tailored content) are used to promote self-efficacy, engagement, knowledge, and behavior change. Objective This study aimed to review a broad spectrum of digital health interventions in the literature seeking trials that use SCTs for the design of eHealth applications. Methods The author conducted a systematic scoping review of 161 Web-based health interventions from published randomized clinical trials using 1 or more tools to address the social cognitive determinants in their website design from January 2006 to April 2016. An iterative approach was used in the selection of studies and data extraction. The studies were analyzed for quality and coded for type of social design features employed. Results Expressive interaction tools were found in 48.6% (54/111) of studies categorized as a strong recommendation by the Joanna Briggs Institute criteria. Overall, less than half of the studies addressed participant social support and motivational needs (43.8%). The vast majority of studies (100%) relied on the use of the Web for delivery of informational aid and tailored content for the individual participant (75.9%). Conclusions This review fills a research gap by linking social theory to Web strategy to improve the impact and sustainability of eHealth interventions. A Digital Health Intervention Model was developed to provide a framework to enhance future Web-based health intervention design and execution.
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Hudgel DW, Patel SR, Ahasic AM, Bartlett SJ, Bessesen DH, Coaker MA, Fiander PM, Grunstein RR, Gurubhagavatula I, Kapur VK, Lettieri CJ, Naughton MT, Owens RL, Pepin JLD, Tuomilehto H, Wilson KC. The Role of Weight Management in the Treatment of Adult Obstructive Sleep Apnea. An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med 2018; 198:e70-e87. [DOI: 10.1164/rccm.201807-1326st] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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11
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Young MD, Morgan PJ. Effect of a Gender-Tailored eHealth Weight Loss Program on the Depressive Symptoms of Overweight and Obese Men: Pre-Post Study. JMIR Ment Health 2018; 5:e1. [PMID: 29317379 PMCID: PMC5780613 DOI: 10.2196/mental.8920] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 10/18/2017] [Accepted: 10/29/2017] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Obesity and depression are of two of the largest contributors to the global burden of disease in men. Although lifestyle behavior change programs can improve participants' weight and depressive symptoms, the evidence is limited by a lack of male participants and a reliance on face-to-face treatment approaches, which are not accessible or appealing for many men. OBJECTIVE This study examined the effect of a gender-tailored electronic health (eHealth) program on the depressive symptoms of a community sample of overweight and obese men with or without depression. A secondary aim was to determine whether the eHealth, self-directed format of the program was a feasible and acceptable treatment approach for the subgroup of men with depression at baseline. METHODS In total, 209 overweight/obese men from the Hunter Region of Australia were assessed before and after completing a self-administered eHealth weight loss program over 3 months. To increase engagement, most program elements were socio-culturally targeted to appeal specifically to men and included printed materials, a DVD, motivational text messages, online- or app-based self-monitoring, and other weight loss tools (eg, pedometer). Depressive symptoms were measured with the validated 8-item Patient Health Questionnaire (PHQ-8). Program feasibility and acceptability were assessed with a process questionnaire plus recruitment and retention rates. Changes in depressive symptoms and weight were examined using intention-to-treat linear mixed models, adjusted for the centered baseline score and other covariates. Effect sizes were estimated with Cohen's d. RESULTS At baseline, the mean weight and age of the sample was 105.7 kg (standard deviation [SD] 14.0) and 46.6 years (SD 11.3), respectively. Overall, 36 men (36/209, 17.2%) were experiencing depression (PHQ-8 score ≥10). Retention rates were comparable between men with and without depression (32/36, 88.9% vs 145/173, 83.8%; P=.44). At posttest, depressive symptoms had reduced by 1.8 units (95% CI 1.3 to 2.3; P<.001; d=0.5) for the whole sample. These improvements were particularly notable in the subgroup of men with depression (-5.5 units; P<.001; d=1.0) and 72.2% (26/36) of this subgroup no longer met the criterion for depression at posttest. A corresponding, albeit smaller, intervention effect on depressive symptoms was also observed in men without depression (-1.0 units; P<.001; d=0.4). The overall intervention effect on weight was -4.7 kg (d=1.3), which did not vary significantly by depression status. Program acceptability, feasibility, and online engagement metrics were also comparable between men with and without depression. CONCLUSIONS A gender-tailored eHealth lifestyle program generated short-term improvements in the mental health of overweight and obese men, particularly for men with depression at baseline. Despite receiving no personalized support, men with depression reported high levels of satisfaction and engagement with the program. As such, a longer-term controlled trial testing an adapted version of the program for this subgroup is warranted. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12612000749808; https://www.anzctr.org.au/ Trial/Registration/TrialReview.aspx?id=362575 (Archived by WebCite at http://www.webcitation.org/6wJvbRsNW).
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Affiliation(s)
- Myles D Young
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Philip J Morgan
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
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Young MD, Morgan PJ. Paternal Physical Activity: An Important Target to Improve the Health of Fathers and their Children. Am J Lifestyle Med 2017; 11:212-215. [PMID: 30202332 PMCID: PMC6125078 DOI: 10.1177/1559827616689544] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Although the transition to fatherhood is joyful and fulfilling for many men, becoming a father also exposes men to a series of new challenges and responsibilities that can negatively affect their well-being. As such, effective strategies that foster positive physical and mental health in fathers are required. Given the established links between regular physical activity and optimal health, strategies to reduce the substantial decline in physical activity typically observed during the early fatherhood may be particularly fruitful. In this commentary, we discuss the potential mediating role of physical activity on a series of important outcomes for fathers, including paternal and child health and the quality of the father-child relationship. We also present an argument that high-quality research studies testing physical activity interventions that meaningfully engage fathers are urgently required.
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Affiliation(s)
- Myles D. Young
- Myles D. Young, PhD, Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, University Drive, New South Wales 2308, Australia; e-mail:
| | - Philip J. Morgan
- Priority Research Centre for Physical Activity and Nutrition (MDY, PJM), University of Newcastle, Callaghan, New South Wales, Australia
- School of Education, Faculty of Education and Arts (MDY, PJM), University of Newcastle, Callaghan, New South Wales, Australia
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Aguiar EJ, Morgan PJ, Collins CE, Plotnikoff RC, Young MD, Callister R. Process Evaluation of the Type 2 Diabetes Mellitus PULSE Program Randomized Controlled Trial: Recruitment, Engagement, and Overall Satisfaction. Am J Mens Health 2017; 11:1055-1068. [PMID: 28423969 PMCID: PMC5675346 DOI: 10.1177/1557988317701783] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background: Men are underrepresented in weight loss and type 2 diabetes mellitus (T2DM) prevention studies. Purpose: To determine the effectiveness of recruitment, and acceptability of the T2DM Prevention Using LifeStyle Education (PULSE) Program—a gender-targeted, self-administered intervention for men. Methods: Men (18–65 years, high risk for T2DM) were randomized to intervention (n = 53) or wait-list control groups (n = 48). The 6-month PULSE Program intervention focused on weight loss, diet, and exercise for T2DM prevention. A process evaluation questionnaire was administered at 6 months to examine recruitment and selection processes, and acceptability of the intervention’s delivery and content. Associations between self-monitoring and selected outcomes were assessed using Spearman’s rank correlation. Results: A pragmatic recruitment and online screening process was effective in identifying men at high risk of T2DM (prediabetes prevalence 70%). Men reported the trial was appealing because it targeted weight loss, T2DM prevention, and getting fit, and because it was perceived as “doable” and tailored for men. The intervention was considered acceptable, with men reporting high overall satisfaction (83%) and engagement with the various components. Adherence to self-monitoring was poor, with only 13% meeting requisite criteria. However, significant associations were observed between weekly self-monitoring of weight and change in weight (rs = −.47, p = .004) and waist circumference (rs = −.38, p = .026). Men reported they would have preferred more intervention contact, for example, by phone or email. Conclusions: Gender-targeted, self-administered lifestyle interventions are feasible, appealing, and satisfying for men. Future studies should explore the effects of additional non-face-to-face contact on motivation, accountability, self-monitoring adherence, and program efficacy.
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Affiliation(s)
- Elroy J Aguiar
- 1 Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia.,2 School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - Philip J Morgan
- 1 Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia.,3 School of Education, Faculty of Education and Arts, The University of Newcastle, Callaghan, NSW, Australia
| | - Clare E Collins
- 1 Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia.,4 School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - Ronald C Plotnikoff
- 1 Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia.,3 School of Education, Faculty of Education and Arts, The University of Newcastle, Callaghan, NSW, Australia
| | - Myles D Young
- 1 Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia.,3 School of Education, Faculty of Education and Arts, The University of Newcastle, Callaghan, NSW, Australia
| | - Robin Callister
- 1 Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia.,2 School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
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Young MD, Callister R, Collins CE, Plotnikoff RC, Aguiar EJ, Morgan PJ. Efficacy of a gender-tailored intervention to prevent weight regain in men over 3 years: A weight loss maintenance RCT. Obesity (Silver Spring) 2017; 25:56-65. [PMID: 27925437 DOI: 10.1002/oby.21696] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 09/25/2016] [Accepted: 09/27/2016] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To examine whether a gender-tailored weight loss maintenance (WLM) program could reduce men's weight regain following weight loss. METHODS Ninety-two men who lost at least 4 kg during a 3-month weight loss phase were randomized to receive: (i) a 6-month WLM program (WL + WLM; n = 47) or (ii) no resources (WL-only; n = 45). The WLM program included written materials and messages (SMS, video email) plus other resources (e.g., pedometer, Gymstick™). The primary outcome was weight change in the first year post-randomization. Participants were assessed at "-3 months" (preweight loss), "0 months" (randomization into the WLM Phase), "6 months," "1 year," and "3 years." RESULTS Before randomization, participants lost a mean (SD) of 7.3 kg (2.5). Retention was 83% at 6 months and 1 year and 71% at 3 years. Intention-to-treat analysis detected a significant group × time difference in weight regain favoring the intervention group at 6 months (-1.9 kg, 95% CI -3.7 to -0.1) but not at 1- or 3-year follow-up. Three years after completing the original weight loss program the WL-only and WL + WLM groups had maintained 59% and 51% of their initial weight loss, respectively. CONCLUSIONS Men with overweight/obesity demonstrated clinically meaningful WLM 3 years after successfully losing weight. An additional WLM program contributed to enhanced WLM effects in the short term only. (ACTRN12612000749808).
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Affiliation(s)
- Myles D Young
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
- School of Education, Faculty of Education and Arts, University of Newcastle, Callaghan, New South Wales, Australia
| | - Robin Callister
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia
| | - Clare E Collins
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia
| | - Ronald C Plotnikoff
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
- School of Education, Faculty of Education and Arts, University of Newcastle, Callaghan, New South Wales, Australia
| | - Elroy J Aguiar
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia
| | - Philip J Morgan
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
- School of Education, Faculty of Education and Arts, University of Newcastle, Callaghan, New South Wales, Australia
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Young MD, Plotnikoff RC, Collins CE, Callister R, Morgan PJ. A Test of Social Cognitive Theory to Explain Men’s Physical Activity During a Gender-Tailored Weight Loss Program. Am J Mens Health 2016; 10:NP176-NP187. [DOI: 10.1177/1557988315600063] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Physical inactivity is a leading contributor to the burden of disease in men. Social–cognitive theories may improve physical activity (PA) interventions by identifying which variables to target to maximize intervention impact. This study tested the utility of Bandura’s social cognitive theory (SCT) to explain men’s PA during a 3-month weight loss program. Participants were 204 overweight/obese men ( M [ SD] age = 46.6 [11.3] years; body mass index = 33.1 [3.5] kg/m2). A longitudinal, latent variable structural equation model tested the associations between SCT constructs (i.e., self-efficacy, outcome expectations, intention, and social support) and self-reported moderate-to-vigorous PA (MVPA) and examined the total PA variance explained by SCT. After controlling for Time 1 cognitions and behavior, the model fit the data well (χ2 = 73.9, degrees of freedom = 39, p < .001; normed χ2 = 1.9; comparative fit index = 0.96; standardized root mean residual = 0.059) and explained 65% of the variance in MVPA at Time 2. At Time 2, self-efficacy demonstrated the largest direct and total effects on MVPA (βdirect = .45, p < .001; βtotal = .67, p = .002). A small-to-medium effect was observed from intention to MVPA, but not from outcome expectations or social support. This study provides some evidence supporting the tenets of SCT when examining PA behavior in overweight and obese men. Future PA and weight loss interventions for men may benefit by targeting self-efficacy and intention, but the utility of targeting social support and outcome expectations requires further examination.
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Aguiar EJ, Morgan PJ, Collins CE, Plotnikoff RC, Young MD, Callister R. Efficacy of the Type 2 Diabetes Prevention Using LifeStyle Education Program RCT. Am J Prev Med 2016; 50:353-364. [PMID: 26526160 DOI: 10.1016/j.amepre.2015.08.020] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 07/20/2015] [Accepted: 08/04/2015] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Self-administered lifestyle interventions have been suggested as an alternative to face-to-face delivery modes, although their efficacy remains uncertain. The aim of this study was to evaluate the efficacy of the Type 2 diabetes mellitus Prevention Using LifeStyle Education (PULSE) Program, a self-administered and gender-tailored lifestyle intervention for men at high risk for developing Type 2 diabetes mellitus. DESIGN/SETTING A 6-month, assessor-blinded, parallel-group RCT was conducted at the University of Newcastle, Australia in 2012-2013. PARTICIPANTS Men (aged 18-65 years, BMI 25-40 kg/m(2), high risk for developing Type 2 diabetes mellitus) were stratified by age (<50 and >50 years) and BMI category (25.0-29.9, 30.0-35.9, and 35.0-40 kg/m(2)) and individually randomized (1:1 ratio) to the intervention (n=53) or waitlist control groups (n=48). INTERVENTION The intervention group received the PULSE Program, which contained print and video resources on weight loss (Self-Help, Exercise and Diet using Internet Technology [SHED-IT] Weight Loss Program), diet modification, and exercise for Type 2 diabetes mellitus prevention. The waitlist control group received no information until 6 months. MAIN OUTCOME MEASURES Data were collected from September 2012 to September 2013 and analyzed in 2014-2015. Linear mixed models (intention-to-treat) were used to determine group X time interactions (differences between groups in changes over time) at 6 months for the primary outcome (weight), glycated hemoglobin, and several secondary outcomes (significance level, p<0.05). RESULTS Differences between groups in mean changes from baseline to 6 months (group × time interaction) favored the intervention over control group for weight loss (-5.50 kg, 95% CI=-7.40 kg, -3.61 kg, p<0.001, Cohen's d=1.15), glycated hemoglobin (-0.2%, 95% CI=-0.3%, -0.1%, p=0.002, d=0.64), and BMI, waist circumference, body fat percentage, aerobic fitness, and lower body muscular fitness (all p<0.05). No group × time effects were observed for fasting plasma glucose, upper body muscular fitness, physical activity, or energy intake. CONCLUSIONS The PULSE Program improved several Type 2 diabetes mellitus risk factors in men, including weight and glycated hemoglobin. These findings provide evidence for a self-administered and gender-tailored lifestyle intervention, which has potential for dissemination in community settings.
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Affiliation(s)
- Elroy J Aguiar
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia; School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia.
| | - Philip J Morgan
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia; School of Education, Faculty of Education and Arts, University of Newcastle, Callaghan, New South Wales, Australia
| | - Clare E Collins
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia; School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia
| | - Ronald C Plotnikoff
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia; School of Education, Faculty of Education and Arts, University of Newcastle, Callaghan, New South Wales, Australia
| | - Myles D Young
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia; School of Education, Faculty of Education and Arts, University of Newcastle, Callaghan, New South Wales, Australia
| | - Robin Callister
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia; School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia
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Interdisciplinary lifestyle intervention for weight management in a community population (HealthTrack study): Study design and baseline sample characteristics. Contemp Clin Trials 2015; 45:394-403. [DOI: 10.1016/j.cct.2015.10.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 10/14/2015] [Accepted: 10/17/2015] [Indexed: 11/22/2022]
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Young MD, Plotnikoff RC, Collins CE, Callister R, Morgan PJ. Impact of a male-only weight loss maintenance programme on social-cognitive determinants of physical activity and healthy eating: A randomized controlled trial. Br J Health Psychol 2015; 20:724-44. [PMID: 25777588 DOI: 10.1111/bjhp.12137] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 02/18/2015] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To examine the effect of a gender-tailored, Social Cognitive Theory (SCT)-based weight loss maintenance (WLM) intervention on men's physical activity and healthy eating cognitions and behaviours in the 12 months after completing a weight loss programme. DESIGN A two-phase, assessor-blinded, randomized controlled trial. METHODS Ninety-two overweight/obese men (mean [SD] age: 49.2 years [10.1], BMI: 30.7 [3.3] kg/m(2) ) who lost at least 4 kg after completing the 3-month SCT-based SHED-IT Weight Loss Program were randomly allocated to receive (1) the SCT-based SHED-IT WLM Program; or (2) no additional resources (self-help control group). The 6-month gender-tailored SHED-IT WLM Program was completely self-administered and operationalized SCT behaviour change principles to assist men to increase moderate-to-vigorous physical activity (MVPA) and decrease energy-dense, nutrient-poor (discretionary) food consumption after initial weight loss. After randomization (WLM baseline), men were reassessed at 6 months (WLM post-test) and 12 months (6-month WLM follow-up). SCT cognitions (e.g., self-efficacy, goal setting), MVPA, and discretionary food consumption were assessed with validated measures. RESULTS Following significant improvements in cognitions, MVPA and discretionary food consumption during the weight loss phase, intention-to-treat, linear mixed models revealed no significant group-by-time differences in cognitions or behaviours during the WLM phase. Initial improvements in MVPA and some cognitions (e.g., goal setting, planning, and social support) were largely maintained by both groups at the end of the study. Dietary effects were not as strongly maintained, with the intervention and control groups maintaining 57% and 75% of the Phase I improvements in discretionary food intake, respectively. CONCLUSIONS An additional SCT-based WLM programme did not elicit further improvements over a self-help control in the cognitions or behaviours for MVPA or discretionary food intake of men who had lost weight with a SCT-based weight loss programme. Statement of contribution What is already known on this subject?Weight regain after weight loss (WL) is common. As successful weight loss maintenance (WLM) requires sustained improvements in cognitions and behaviours, health psychology can contribute to intervention development. However, little research has examined the utility of psychological theory in the context of a WLM randomised controlled trial. What does this study add? A theory-based WL program improved men's physical activity and dietary behaviours and cognitions. Men who also received a theory-based WLM program did not show further improvements in physical activity or dietary cognitions and behaviours compared to those that did not.
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Affiliation(s)
- Myles D Young
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
| | - Ronald C Plotnikoff
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
| | - Clare E Collins
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
| | - Robin Callister
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
| | - Philip J Morgan
- Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
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The PULSE (Prevention Using LifeStyle Education) trial protocol: a randomised controlled trial of a Type 2 Diabetes Prevention programme for men. Contemp Clin Trials 2014; 39:132-44. [PMID: 25092484 DOI: 10.1016/j.cct.2014.07.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 07/22/2014] [Accepted: 07/23/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND Intensive lifestyle interventions have been successful in reducing type 2 diabetes incidence. Whether intensive programmes requiring face-to-face contact, trained staff and access to facilities are feasible, on a larger scale, has been debated. OBJECTIVES The aim of this study is to determine the feasibility and efficacy of a lifestyle intervention for type 2 diabetes prevention in men using an assessor-blinded, parallel-group, randomised controlled trial. The 'Type 2 Diabetes PULSE (Prevention Using LifeStyle Education) Programme for Men' is a 6-month, self-administered, gender-tailored lifestyle intervention, with a multicomponent approach (weight loss, dietary modification, aerobic exercise and resistance training). Eligible men were aged 18-65 years, overweight/obese (BMI 25-40 kg·m(-2)) and at high-risk for type 2 diabetes (score ≥ 12, Australian diabetes risk tool). Men with diagnosed prediabetes were eligible, but those with type 1 and 2 diabetes were ineligible. Randomisation was stratified by age (<50 or ≥ 50 years) and BMI category (kg·m(-2): 25-29.9; 30-34.9; 35-40) to the intervention or wait-list control group. Data are collected at study entry (baseline), 3 and 6 months. The primary outcome is weight change at 6 months. Secondary outcomes include: fasting plasma glucose, HbA1C, waist circumference, body composition, blood pressure, diet quality, aerobic fitness, muscular fitness and physical activity. Generalised linear mixed models (intention-to-treat) will assess outcomes for treatment (intervention vs. control), time (baseline, 3 and 6-months) and the treatment-by-time interaction. CONCLUSION The results will determine the efficacy of a type 2 diabetes prevention programme for men with potential for wide reach and dissemination. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ACTRN12612000721808).
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